The patient-clinician interaction is central to mind-body therapies, including acupuncture, where psychosocial factors, such as clinician empathy and therapeutic alliance, are the source of key mechanisms of action. While self-report assessments of therapeutic alliance correlate with clinical outcomes, such subjective measures do not reflect objective moment-to-moment dynamics underlying these psychosocial interactions. Importantly, the brain has a mirror neuron circuitry, which supports the ability of an observed experience in another to be experienced as if it were in the self, a function critical for social communication. Mirror neuron networks were first reported for overlap in observed and produced movements, and have now been described for both somatosensory (e.g. observed, imagined, or vicarious touch), and social (e.g. empathy) mirroring. Moreover, activation of social mirroring networks synchronizes between individuals when socially interacting, and stronger coupling may reflect more successful communication. We propose that patient-clinician concordance in social mirror networks during therapy represents an important mechanism of acupuncture and is strongly correlated with therapeutic alliance. To test our hypotheses, we have successfully set up an experiment with simultaneously recorded functional Magnetic Resonance Imaging (fMRI hyperscanning) in patient-clinician dyads, who interact via video transfer, during clinician-initiated treatment of patients’ pain. We hypothesized concordant activation of circuitry involved in social mirroring, such as ventrolateral Prefrontal Cortex (vlPFC) and anterior Insula (aINS) in both patients and clinicians during pain treatment. This webinar talk will provide a background in prior attempts to understand the physiological correlates of therapeutic alliance and present some of the preliminary results from our own ongoing research study.
Vitaly Napadow, Ph.D., LAc.
Martinos Center for Biomedical Imaging
Massachusetts General Hospital and Harvard Medical School
Director of the Center for Integrative Pain Neuroimaging
Vitaly Napadow is an Associate Professor at the Martinos Center for Biomedical Imaging at Massachusetts General Hospital and Harvard Medical School, and the Director of the Center for Integrative Pain Neuroimaging (CiPNI). Over the past 15 years, he has applied his biomedical engineering background to neuroscience and neuroimaging research aimed at improving treatment options for patients suffering from chronic pain. Dr. Napadow’s laboratory has pioneered the application of non-invasive neuroimaging techniques to better understand the brain circuitry underlying aversive perceptual states such as pain, nausea, and itch, and to better understand how non-pharmacological therapies such as cognitive behavioral therapy and acupuncture ameliorate these states. Dr. Napadow is also the co-President of the Society for Acupuncture Research and has more than 120